Mantle cell lymphoma of the larynx: Primary case report

INTRODUCTION: Primary laryngeal lymphomas are exceedingly rare. Only about a hundred cases have been reported. They consist mainly of non-Hodgkin lymphoma, especially of diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue. We report the first case of a primary laryngeal mantle cell lymphoma. CASE PRESENTATION: We report a case of a primary mantle cell lymphoma of the larynx in a 70-year-old North African non-smoker male. We present a detailed report of his clinical and paraclinical data as well as treatment options. CONCLUSIONS: Mantle cell lymphoma is a very aggressive lymphoma subset associated with poor prognosis. Laryngeal mantle cell lymphoma is exceedingly rare. To the best of our knowledge, this is the first case to ever be reported

Unusual case of cavitary lung metastasis from squamous cell carcinoma of the uterine cervix

Spontaneous excavation of primary lung cancer is common; however cavitation of metastatic lung lesions is rare and usually confused with benign lesions. In Moroccan context tuberculosis is the first suspected diagnosis of lung excavations. We report a rare case of cavitary lung metastasis of a uterine cervix cancer, treated initially as tuberculosis. A 40-year old non-smoking woman with a known history of squamous cell carcinoma of the uterine cervix since August 2005; presented on September 2008 with right chest pain without fever, hemoptysis or weight loss. CT scan showed a thin walled cavity. Empirical Antibiotic therapy was conducted 15 days with poor outcome. Then antibacillary treatment was started with no proof of mycobacterial infection. A month later, the patient presented with gynecological bleeding and a pneumothorax. Bronchoscopy with transbronchial biopsy of the cavitary mass was performed. Pathology demonstrated a metastatic squamous cell carcinoma. Pelvic examination and MRI showed a subsequent local cervix recurrence. Patient underwent 3 courses of systemic chemotherapy. She died on June 2009 due to progressive disease. Even cavitary lung metastases are rare and benign differential diagnosis are more common, clinician should be careful in neoplastic context and investigation should be done to eliminate a recurrence.Pan African Medical Journal 2013; 14:3

Primary pleural leiomyosarcoma with rapid progression and fatal outcome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Leiomyosarcomas are neoplasms of smooth muscles that most commonly arise from the uterus, gastrointestinal tract, or soft tissue. Primary pleural leiomyosarcoma is extremely rare. To the best of our knowledge, only nine cases have been published to date. Because of the rarity of pleural leiomyosarcoma and its similarity (clinical and histological) to other pleural neoplasms, particularly sarcomatous mesothelioma, diagnosis is often difficult.</p> <p>Case presentation</p> <p>A 58-year-old North African man was admitted with complaints of dyspnea and chest pain to our hospital. Chest computed tomography revealed right pleural effusion and pleural thickening. A transthoracic needle biopsy yielded a diagnosis of leiomyosarcoma, and tumor cells were strongly and uniformly positive for vimentin, a smooth muscle actin at immunohistochemical analysis. A general examination did not show any metastatic lesions in other areas. One month after diagnosis, the tumor grew rapidly, with pulmonary invasion, and therefore he was treated only by palliative care. He died from respiratory failure one month later. Because no organ of origin of the leiomyosarcoma, other than the pleura, was detected, this case was diagnosed as a primary pleural leiomyosarcoma.</p> <p>Conclusions</p> <p>Although leiomyosarcoma originating from the pleura is rare, this entity is increasingly described. The purpose of presenting this case report is to raise awareness among clinicians to consider this clinical entity as a differential diagnosis when a pleural mass is identified.</p

Évaluation clinique de L’ANTI-VEGF dans le cancer colo-réctal métastatique : essai phase ii

L’association du Bevacizumab à la chimiothérapie standard a prouvé son efficacité dans le traitement du cancer colorectal métastatique ; son utilisation à l’échelle nationale est récente. Le but de notre travail est l’évaluation du profil de tolérance et de l’efficacité du Bevacizumab en association à la chimiothérapie dans notre contexte. 37 dossiers de cancer colorectal métastatique ont été étudiés de façon prospective de Mars 2005 à Février 2008, dans le service d’oncologie médicale à l’institut national d’oncologie de Rabat. L’analyse systématique de ces dossiers a permis d’établir le profil de sécurité du Bevacizumab, ainsi que son efficacité. Le Bevacizumab a été associé aux protocoles de chimiothérapie standard à base de 5FU, capécitabine, oxaliplatine et irinotecan. Il a été administré selon deux modalités : 5mg /kg/15 jours ou 7,5mg/kg/21jours. 22 patients avaient reçu en première ligne, et 11 patients en deuxième ligne de traitement. Les effets indésirables observés étaient l’hypertension artérielle (10,8% des cas), la protéinurie (13,5%), les syndromes hémorragiques (8,1%), 42% des malades n’avaient présenté aucune toxicité. Les taux de réponse objective étaient de 31,8% en première ligne et 27% en deuxième ligne, la durée de survie était de 18 mois en 1ère ligne et 22 mois en 2ème ligne, le temps médian jusqu’à progression était de 6 mois en 1ère ligne et 9 mois en 2ème ligne. La comparaison de nos résultats avec les essais de la littérature montre une concordance concernant les profils de tolérance et d’efficacité. Le Bevacizumab permettait un allongement significatif de la durée de survie, du temps de progression et du taux de réponse, quelque soit le protocole de chimiothérapie associé en 1ère ou en 2ème ligne. Il était globalement bien toléré hormis l’hypertension artérielle qui pouvait être jugulée par un simple traitement oral. L’utilisation du Bevacizumab est récente dans notre pays, les premiers résultats semblent être prometteurs, le problème posé réside dans le coût élevé limitant son utilisation